Julie Kaplow, Ph.D.
“I hope that the research I am doing will help inform early prevention and intervention efforts for children who are faced with parental illness or loss.”
As Julie Kaplow was beginning her career in clinical child psychology, she was struck by how profoundly the loss of a loved one could affect children, as well as how varied their reactions could be. What she also found remarkable was how little information was available to help kids through the grieving process. This motivated her to begin exploring how children grieve, and to learn more about what fuels their resilience in the face of bereavement and other life stressors.
Although most children who experience a loss “are resilient, and do heal and recover,” Kaplow says, an important subgroup of these children will go through what she calls “maladaptive bereavement” or “pathological grief,” in contrast to a more typical “adaptive” grieving process. “For kids who are experiencing maladaptive grief, they tend to get stuck in the grief process, so that they end up not being able to think about or talk about the deceased person because those memories are accompanied by feelings of intense anxiety or depression,” Kaplow says.
Kaplow’s research seeks to more precisely define what constitutes maladaptive bereavement and how it is differentiated from normal bereavement in children. One goal is to improve our ability to help identify those children who will ultimately have a more difficult time confronting the loss of a parent. Part of this research looks at innate characteristics as well as factors in a child’s social environment that may put these children either more or less at risk for certain mental health outcomes, such as depression, post-traumatic stress disorder (PTSD), or maladaptive bereavement. She especially appreciates the advantages of approaching the topic of pathological grief within the multidisciplinary setting of the Depression Center. “The best treatments now tend to target biological factors, psychological factors, and environmental factors that are impacting children. So without that multidisciplinary component, our research would not be as directly applicable to intervention efforts.”
Kaplow also works to identify what helps children deal with having a parent living with cancer, which grew out of her work with bereaved children. “Recently bereaved children were telling us that the hardest part for them was not the death itself, but the events leading up to the death. So things like watching a parent go through a very invasive medical procedure, having a lot of ambiguity or confusion around the parents’ prognosis, those things seem to be particularly stressful and anxiety-provoking for kids.” Kaplow hopes this work will “help us determine the most effective way that medical practitioners or parents can talk to kids about cancer, and to help prevent the excessive stress and anxiety that is often accompanied by learning about a parent who has cancer.”
While Kaplow is involved in patient care, research, and teaching, she’s also the author of a children’s book on bereavement, Samantha Jane’s Missing Smile. “I wrote it because, as I was trying to help bereaved children through my clinical work, I realized that there was really nothing out there that captured the range of emotions that bereaved children may have,” she says. “It’s difficult to find a way to speak to kids that really resonates with them, and I think that books are a great way to convey important messages to children.”
What most excites Julie Kaplow are the advances in using empirical studies (including her own longitudinal study of bereaved children) to refine diagnostic criteria related to bereavement – historically built around adults and applied to children without much customization – to meet the needs of children of different ages. In the past, “people had primarily considered children’s grief reactions through the lens of depression and not necessarily through the lens of posttraumatic stress. I see that shifting now, so that there is currently more attention being given to the circumstances of the death, the child’s dependence on the person who died, and his or her potentially traumatic reaction to that kind of loss.”
“I hope that what I am doing will eventually be able to help a population of children who have been relatively overlooked and that I can share my knowledge with trainees who are just as excited about the work as I am,” she says.